strategies for evaluating the effectiveness of electronic health records

Clin Biochem Rev. Bernstam EV, Hersh WR, Sim I, Eichmann D, Silverstein JC, Smith JW, Becich MJ: Unintended consequences of health information technology: a need for biomedical informatics. PubMed  Additionally, third parties involved in regulatory, reimbursement, or quality improvement activities (e.g., regional extension centers, payers, or medical societies) can facilitate the development and dissemination of a basic set of guidelines as a starting point. Westerman RF, Hull FM, Bezemer PD, Gort G: A study of communication between general practitioners and specialists. 10.1136/qshc.2010.042085. J Dent Hyg. The Strategic Importance of Electronic Health Records Management: Checklist for Transition to the EHR This checklist assists in the transition from paper to an electronic health record (EHR) as a legal medical record. EHRs offer a robust platform for integrating referral guidelines into providers’ workflows at the point of care, and referral guidelines can improve the referral process in several ways. Failure of consultants to provide follow-up information. 10.1001/archinte.1984.00350180209029. Health Serv Res. 10.1016/S1386-5056(99)00027-1. Reti SR, Feldman HJ, Ross SE, Safran C: Improving personal health records for patient-centered care. In fact, no available turn-key EHR system can fully support the complexities of most referral processes. 2009, 302: 1111-1113. The service requires full JavaScript support in order to view this website. 2005, 20: 953-957. 2010, 29: 647-654. 1984, 144: 1265-1268. Hence, EHRs aimed at supporting referral communication should include functionality to allow the patient to provide additional information if and when needed, and to permit patients to become an active decision-maker during the referral process (i.e. 1995, 4: 403-409. J Gen Intern Med. A randomized controlled trial protocol. Dr. Singh is supported by an NIH K23 career development award (K23CA125585), the VA National Center of Patient Safety, and in part by the Houston VA HSR&D Center for Excellence (HFP90-020). 2006, 2006: 871-. Qual Saf Health Care. 2010, 19: e27-. 2011, 171: 56-65. Am J Med. Sittig DF, Ash JS, Zhang J, Osheroff JA, Shabot MM: Lessons from “Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system.”. Evaluating and Selecting an EHR System The number, variety and complexity of EHR systems in today’s market has made the search for a system complex and sometimes intimidating for many physician practices. 2010, 304: 2407-2408. Int J Med Inform. 1 In the United States, the progress has been slow in spite of the 2004 executive order that set the goal of universal EHRs by 2014. Get 1:1 help now from expert Nursing tutors A clear and common understanding of referral processes with documented policies and procedures of how the technology should be used by PCPs, specialists, and supporting staff is essential for success. Clinical alerts; Data analytics; Electronic prescribing; Integrated billing; Patient portals; Security protocols Mitus AJ: The birth of InterQual: evidence-based decision support criteria that helped change healthcare. is using a security service for protection against online attacks. 1988, 297: 437-438. 2000, 7: 277-286. Esquivel A, Dunn K, McLane S, Te’eni D, Zhang J, Turley JP: When your words count: a discriminative model to predict approval of referrals. Here are a few additional EHR evaluation checklist items worth considering. J Gen Intern Med. The service requires full cookie support in order to view this website. To understand the complexities of the emerging electronic health record system, it is helpful to know what the health information system has been, is now, and needs to become. Recommendations are relevant to system designers, practicing clinicians, and other stakeholders considering use of electronic health records to support referral communication. Newton J, Eccles M, Hutchinson A: Communication between general practitioners and consultants: what should their letters contain?. N Engl J Med. Google Scholar. Previous question Next question Get more help from Chegg. Br J Gen Pract. People comprise one of the key dimensions of the socio-technical model. 2006, 13: 121-126. Continuous monitoring and frequent assessments of several process measurements (e.g., completed referrals, no-shows/missed appointments, and denied or cancelled referrals) should be part of the organization’s ongoing efforts to ensure the effectiveness of their electronic referral communication practices. Prof Case Manag. PubMed  Article  1987, 2: 93-98. BMJ. 10.1136/jamia.2000.0070277. 10.1001/archinternmed.2010.484. Piterman L, Koritsas S: Part II. With clinicians’ widespread use of electronic health records (EHRs), dissatisfaction with EHRs has become more apparent and the usability of this technology has been identified as a major challenge.1–3 Many EHRs are not prospectively designed, developed, and implemented to support the cognitive needs of clinicians, resulting in stress, frustration, reduced efficiency, and patient safety hazards.4,5 In an effort to promote EHR usability, the Office of the Nationa… The control handbook. BMC Med Inform Decis Mak 12, 107 (2012). The medical record, either paper-based or electronic, is a communication tool that supports clinical decision making, coordination of services, evaluation of the quality and efficacy of care, research, legal protection, education, and accreditation and regulat… Forrest CB, Majeed A, Weiner JP, Carroll K, Bindman AB: Comparison of specialty referral rates in the United Kingdom and the United States: retrospective cohort analysis. Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ: Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption. The proposed usability protocol encourages a user-centered approach to the development of EHR systems. 2008, 4- Improving referral communication using a referral tool within an electronic medical record, Agency for Healthcare Research and Quality. 2010, 17: 192-195. Arch Fam Med. Knowing how and where to begin in EHR system evaluation efforts has been an obstacle that has kept many practices linked to Department of Clinical Effectiveness and Performance Measurement, St. Luke’s Episcopal Health System, Houston, TX, University of Texas School of Biomedical Informatics and the UT-Memorial Hermann Center for Healthcare Quality & Safety, Houston, TX, USA, Houston VA HSR&D Center of Excellence and The Center of Inquiry to Improve Outpatient Safety Through Effective Electronic Communication, both at the Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, VA Medical Center (152), 2002 Holcombe Blvd, Houston, 77030, TX, USA, You can also search for this author in This flexibility should be specified in any policies and procedures governing outpatient referrals [58]. Qual Health Care. 1997, 4: 112-124. The conceptual definition of “referral” implies an actual transfer of responsibility for some aspect of the patient’s care and an encounter with another provider. In contrast, a strict consultation involves seeking a colleague’s opinion about a particular aspect of the care of the patient, but at no time is the patient under the direct care of the consultant [1, 87]. Health Aff (Millwood). Katz MH: How can we know so little about physician referrals?. Edited by: Henriksen K, Battles JB, Keyes MA, Grady ML Rockville MD. 2010, 157: 175-180. As with any health information technology-related process, referral communication should be monitored and revised, as needed, [43] to ensure that all stakeholders’ needs are being met in a safe and efficient manner. EHR-based referrals thus would be an essential component of patient care through ACOs. Forrest CB: A typology of specialists’ clinical roles. EHR-based referrals offer the possibility of greatly improving existing outpatient referral processes. Terms and Conditions, McCullough JS, Casey M, Moscovice I, Prasad S: The effect of health information technology on quality in U.S. hospitals. JAMA. J Med Eng Technol. J Clin Oncol. 2002, 325: 370-371. Google Scholar. 2010, 43: 828-830. is using a security service for protection against online attacks. J Am Med Inform Assoc. Magrabi F, Ong M-S, Runciman W, Coiera E: Using FDA reports to inform a classification for health information technology safety problems. This model uses 8 interrelated dimensions to identify challenges related to developing, implementing, and using information technology within health care (hardware & software, clinical content, human-computer interface, people, workflow & communication, organizational features, external rules and regulations, and measurement & monitoring). Horm Res. Conley J, Jordan M, Ghali WA: Audit of the consultation process on general internal medicine services. Am J Manag Care. BMJ. Singh H, Petersen LA, Daci K, Collins C, Khan M, El-Serag HB: Reducing referral delays in colorectal cancer diagnosis: is it about how you ask?. Sittig DF, Singh H: Eight rights of safe electronic health record use. Robertson KJ: Diabetes and the Internet. Electronic health records (EHRs) have been adopted by multiple countries in the past two decades. Saxena S, Kumar V, Giri V: Telecardiology for effective healthcare services. J Am Med Inform Assoc. Privacy In engineering, a closed-loop control system is one in which feedback is needed to control the states or outputs of a dynamic system [90]. Gaudinat A: Closing the loops in biomedical informatics from theory to daily practice. Recommendations are grounded in a socio-technical model for health information technology [43]. 1971, 6: 39-48. 2011, 6: 84-10.1186/1748-5908-6-84. Electronic systems provide an excellent opportunity to create, maintain, and disseminate the use of standardized templates [64, 65]. More than fifty years ago, Williams et al. California Privacy Statement, General practitioner-specialist referral process. Electronic health records are increasingly being used to facilitate referral communication in the outpatient setting. McPhee SJ, Lo B, Saika GY, Meltzer R: How good is communication between primary care physicians and subspecialty consultants?. Hersh W, Helfand M, Wallace J, Kraemer D, Patterson P, Shapiro S, Greenlick M: A systematic review of the efficacy of telemedicine for making diagnostic and management decisions. Hysong SJ, Esquivel A, Sittig DF, Paul LA, Espadas D, Singh S, Singh H: Towards successful coordination of electronic health record based-referrals: a qualitative analysis. 10.1111/j.1445-5994.2005.00860.x. 10.1038/eye.2008.196. Thus, while electronic referral communication must be comprehensive, it should be implemented in a non-intrusive manner so that information remains available to providers and patients on demand.

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